# AUDUBON DENTAL CENTER, PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AUDUBON DENTAL CENTER, PSC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306029848
- **Legal business name:** AUDUBON DENTAL CENTER, PSC
- **Authorized official:** S. KURTIS WILSON (OWNER)
- **Authorized official phone:** (270) 826-2092

## Contact information

- **Practice address:** 610 CARLTON DR, OWENSBORO, KY 42303-7709
- **Practice address phone:** (270) 683-6623
- **Mailing address:** 716 2ND ST, HENDERSON, KY 42420-3227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/06/2007
- **Last updated:** 12/06/2007